Mattsson N, et al. - The relationship between mild hypokalemia and endpoints in the general population is examined in this study. Based on these outcomes, mild hypokalemia is related to increased stroke-risk and to a lesser degree increased mortality-risk in a general population.

Methods

• For this research, they designed a prospective population study.
• They studied 48-76 year old total 5916 participants from the general population study “Copenhagen City Heart Study.
• They divided participants into groups according to baseline-values of plasma-potassium (potassium); Hypokalemia (<3.7 mmol/L,n=758), normokalemia (3.7-4.5 mmol/L] n=4973, and high-potassium (>4.5 mmol/L,n=185).
• They further divided Hypokalemia into potassium<3.4 and 3.4-3.6 mmol/L.
• The primary endpoints were all-cause mortality and non-fatal validated ischemic stroke.
• AMI was the secondary endpoint.
• They adjusted for conventional risk factors, diuretics and atrial fibrillation (AF) at baseline.

Results

• They observed that the mean potassium in the hypokalemic group was 3.5 mmol/L (range 2.6-3.6) and was related (P<0.05) to increased systolic blood pressure, higher CHA2DS2-VASc-score, and increased utilization of diuretics as compared with normokalemia.
• Baseline AF was equally frequent across groups.
• Median follow-up-time was 11.9 years (Q1-Q3: 11.4-12.5 years).
• Hypokalemia was borderline related to increased stroke-risk in a multivariable Cox model (including adjustment for competing risk) as compared with normokalemia (HR:1.40;95%CI:1.00-1.98).
• The subgroup with potassium<3.4 mmol/L had higher stroke- (HR:2.10;95%CI:1.19-3.73) and mortality-risk (HR:1.32;95%CI:1.01-1.74) as compared with normokalemia.
• Hypokalemia was not related to AMI and no increased risk of mortality was observed with concomitant AMI and hypokalemia.
• There were no associations with high-potassium.